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Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
July, 2008, Vol. 08, Issue 07
The Role of the Q Angle in Anterior Knee Pain
By Whitney Lowe, LMT
Postural distortions can lead to numerous soft-tissue disorders. Clients with these postural challenges often look to the massage therapist to help with the pain or biomechanical challenges that result.In the lower extremity, a large quadriceps angle, more commonly called the Q angle, is a postural distortion involving patellofemoral biomechanics. An exaggerated Q angle can lead to knee pain and knee pathologies, as well as compensations in other regions of the body.1
The degree of the Q angle is determined by measuring two lines superimposed on the lower extremity. One line begins at the tibial tuberosity and continues in a superior direction through the midpoint of the patella. A second line connects the anterior superior iliac spine (ASIS) with the midpoint of the patella. The angle between these two lines is the Q angle (Figure 1).
There is a disagreement in the research literature about what constitutes an exaggerated Q angle. Some sources say a Q angle as small as 10 degrees can be a problem, while others say it is not an issue until the angle is greater than 20 degrees.2 A challenge with evaluating the Q angle's role is it's not easy to accurately measure the angle. However, repeated investigations have shown people with a larger Q angle have a greater likelihood of developing numerous knee complaints.
To understand how the Q angle contributes to knee pathologies, it's helpful to look at the anatomical relationships in the region. The patella is embedded in the quadriceps tendon. There is a ridge on the underside of the patella that must fit in the trochlear groove between the two condyles of the femur (Figure 2). The patella moves superiorly and inferiorly in this groove during knee flexion and extension.
The patella's ability to track straight in the trochlear groove is determined by the quadriceps' angle of pull. When the Q angle is greater, the quadriceps pull the patella in a more lateral direction. The unequal pull on the patella causes increased tensile stress on soft tissues around the knee. Too much lateral pull on the patella also can drag it against the lateral femoral condyle and eventually cause degeneration of the cartilage on the underside of the patella - a condition known as chondromalacia patellae. Problems associated with the patella and its correct movement during flexion and extension are referred to as patellar tracking disorders. In addition to patellar tracking disorders, a larger Q angle also can be a major factor in patellar subluxation or dislocation, as well as anterior cruciate ligament sprains.
There is an increased incidence of these knee disorders in women and individuals with genu valgum. The Q angle is greater in women due to the wider pelvis, which places the ASIS farther away from the patellar midline, thereby increasing the Q angle. The Q angle also is greater in people who have the genu valgum postural distortion, more commonly known as knock-knees.
Because certain aspects of bony structure, such as a wide pelvis, determine the Q angle, it's difficult to alter the angle with soft-tissue work alone. However, treatments such as massage are helpful for addressing some of the factors that aggravate Q angle problems. For example, an imbalance in tightness between the vastus lateralis and vastus medialis muscles can contribute to patellar tracking disorders. If the vastus lateralis is too tight, it can pull the patella farther in a lateral direction. This situation often occurs in people with a larger Q angle. Comprehensive massage treatment of the vastus lateralis can reduce the distance it pulls the patella in a lateral direction.
There are numerous causes of anterior knee pain. Several of these can be related to an excessive Q angle. It's not necessary to pull out the protractor and determine the exact Q angle. However, a visual estimation of the Q angle can give important clues about the role this postural distortion plays in a variety of pain complaints. In those cases, massage treatment of the quadriceps muscle group and the retinacular fibers around the patella greatly helps reduce the detrimental results of a large Q angle.
Click here for more information about Whitney Lowe, LMT.
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